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On the Natural Faculties
By Galen
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On the Natural Faculties
By Galen
Translated by Arthur John Brock
Book Two
1. In the previous book we demonstrated that not only
Erasistratus, but also all others who would say anything to the
purpose about urinary secretion, must acknowledge that the kidneys
possess some faculty which attracts to them this particular
quality existing in the urine. Besides this we drew attention to
the fact that the urine is not carried through the kidneys into
the bladder by one method, the blood into parts of the animal by
another, and the yellow bile separated out on yet another
principle. For when once there has been demonstrated in any one
organ, the drawing, or so-called epispastic faculty, there is then
no difficulty in transferring it to the rest. Certainly Nature did
not give a power such as this to the kidneys without giving it
also to the vessels which abstract the biliary fluid, nor did she
give it to the latter without also it to each of the other parts.
And, assuredly, if this is true, we must marvel that Erasistratus
should make statements concerning the delivery of nutriment from
the food-canal which are so false as to be detected even by
Asclepiades. Now, Erasistratus considers it absolutely certain
that, if anything flows from the veins, one of two things must
happen: either a completely empty space will result, or the
contiguous quantum of fluid will run in and take the place of that
which has been evacuated. Asclepiades, however, holds that not one
of two, but one of three things must be said to result in the
emptied vessels: either there will be an entirely empty space, or
the contiguous portion will flow in, or the vessel will contract.
For whereas, in the case of reeds and tubes it is true to say
that, if these be submerged in water, and are emptied of the air
which they contain in their lumens, then either a completely empty
space will be left, or the contiguous portion will move onwards;
in the case of veins this no longer holds, since their coats can
collapse and so fall in upon the interior cavity. It may be seen,
then, how false this hypothesis- by Zeus, I cannot call it a
demonstration!- of Erasistratus is.
And, from another point of view, even if it were true, it is
superfluous, if the stomach has the power of compressing the
veins, as he himself supposed, and the veins again of contracting
upon their contents and propelling them forwards. For, apart from
other considerations, no plethora would ever take place in the
body, if delivery of nutriment resulted merely from the tendency
of a vacuum to become refilled. Now, if the compression of the
stomach becomes weaker the further it goes, and cannot reach to an
indefinite distance, and if, therefore, there is need of some
other mechanism to explain why the blood is conveyed in all
directions, then the principle of the refilling of a vacuum may be
looked on as a necessary addition; there will not, however, be a
plethora in any of the parts coming after the liver, or, if there
be, it will be in the region of the heart and lungs; for the heart
alone of the parts which come after the liver draws the nutriment
into its right ventricle, thereafter sending it through the
arterioid vein to the lungs (for Erasistratus himself will have it
that, owing to the membranous excrescences, no other parts save
the lungs receive nourishment from the heart). If, however, in
order to explain how plethora comes about, we suppose the force of
compression by the stomach to persist indefinitely, we have no
further need of the principle of the refilling of a vacuum,
especially if we assume contraction of the veins in addition- as
is, again, agreeable to Erasistratus himself.
2. Let me draw his attention, then, once again, even if he does
not wish it, to the kidneys, and let me state that these confute
in the very clearest manner such people as object to the principle
of attraction. Nobody has ever said anything plausible, nor, as we
previously showed, has anyone been able to discover, by any means,
any other cause for the secretion of urine; we necessarily appear
mad if we maintain that the urine passes into the kidneys in the
form of vapour, and we certainly cut a poor figure when we talk
about the tendency of a vacuum to become refilled; this idea is
foolish in the case of blood, and impossible, nay, perfectly
nonsensical, in the case of the urine.
This, then, is one blunder made by those who dissociate themselves
from the principle of attraction. Another is that which they make
about the secretion of yellow bile. For in this case, too, it is
not a fact that when the blood runs past the mouths [stomata] of
the bile-ducts there will be a thorough separation out [secretion]
of biliary waste-matter. "Well," say they, "let us suppose that it
is not secreted but carried with the blood all over the body."
But, you sapient folk, Erasistratus himself supposed that Nature
took thought for the animals' future, and was workmanlike in her
method; and at the same time he maintained that the biliary fluid
was useless in every way for the animals. Now these two things are
incompatible. For how could Nature be still looked on as
exercising forethought for the animal when she allowed a noxious
humour such as this to be carried off and distributed with the
blood?...
This, however, is a small matter. I shall again point out here the
greatest and most obvious error. For if the yellow bile adjusts
itself to the narrower vessels and stomata, and the blood to the
wider ones, for no other reason than that blood is thicker and
bile thinner, and that the stomata of the veins are wider and
those of the bile-ducts narrower, then it is clear that this
watery and serous superfluity, too, will run out into the
bile-ducts quicker than does the bile, exactly in proportion as it
is thinner than the bile! How is it, then, that it does not run
out? "Because," it may be said, "urine is thicker than bile!" This
was what one of our Erasistrateans ventured to say, herein clearly
disregarding the evidence of his senses, although he had trusted
these in the case of the bile and blood. For, if it be that we are
to look on bile as thinner than blood because it runs more, then,
since the serous residue passes through fine linen or lint or a or
a sieve more easily even than does bile, by these tokens bile must
also be thicker than the watery fluid. For here, again, there is
no argument which will demonstrate that bile is thinner than the
serous superfluities.
But when a man shamelessly goes on using circumlocutions, and
never acknowledges when he has had a fall, he is like the amateur
wrestlers, who, when they have been overthrown by the experts and
are lying on their backs on the ground, so far from recognizing
their fall, actually seize their victorious adversaries by the
necks and prevent them from getting away, thus supposing
themselves to be the winners!
3. Thus, every hypothesis of channels as an explanation of natural
functioning is perfect nonsense. For, if there were not an inborn
faculty given by Nature to each one of the organs at the very
beginning, then animals could not continue to live even for a few
days, far less for the number of years which they actually do. For
let us suppose they were under no guardianship, lacking in
creative ingenuity and forethought; let us suppose they were
steered only by material forces, and not by any special faculties
(the one attracting what is proper to it, another rejecting what
is foreign, and yet another causing alteration and adhesion of the
matter destined to nourish it); if we suppose this, I am sure it
would be ridiculous for us to discuss natural, or, still more,
psychical, activities- or, in fact, life as a whole.
For there is not a single animal which could live or endure for
the shortest time if, possessing within itself so many different
parts, it did not employ faculties which were attractive of what
is appropriate, eliminative of what is foreign, and alterative of
what is destined for nutrition. On the other hand, if we have
these faculties, we no longer need channels, little or big,
resting on an unproven hypothesis, for explaining the secretion of
urine and bile, and the conception of some favourable situation
(in which point alone Erasistratus shows some common sense, since
he does regard all the parts of the body as having been well and
truly placed and shaped by Nature).
But let us suppose he remained true to his own statement that
Nature is "artistic"- this Nature which, at the beginning, well
and truly shaped and disposed all the parts of the animal, and,
after carrying out this function (for she left nothing undone),
brought it forward to the light of day, endowed with certain
faculties necessary for its very existence, and, thereafter,
gradually increased it until it reached its due size. If he argued
consistently on this principle, I fail to see how he can continue
to refer natural functions to the smallness or largeness of
canals, or to any other similarly absurd hypothesis. For this
Nature which shapes and gradually adds to the parts is most
certainly extended throughout their whole substance. Yes indeed,
she shapes and nourishes and increases them through and through,
not on the outside only. For Praxiteles and Phidias and all the
other statuaries used merely to decorate their material on the
outside, in so far as they were able to touch it; but its inner
parts they left unembellished, unwrought, unaffected by art or
forethought, since they were unable to penetrate therein and to
reach and handle all portions of the material. It is not so,
however, with Nature. Every part of a bone she makes bone, every
part of the flesh she makes flesh, and so with fat and all the
rest; there is no part which she has not touched, elaborated, and
embellished. Phidias, on the other hand, could not turn wax into
ivory and gold, nor yet gold into wax: for each of these remains
as it was at the commencement, and becomes a perfect statue simply
by being clothed externally in a form and artificial shape. But
Nature does not preserve the original character of any kind of
matter; if she did so, then all parts of the animal would be
blood- that blood, namely, which flows to the semen from the
impregnated female and which is, so to speak, like the statuary's
wax, a single uniform matter, subjected to the artificer. From
this blood there arises no part of the animal which is as red and
moist [as blood is], for bone, artery, vein, nerve, cartilage,
fat, gland, membrane, and marrow are not blood, though they arise
from it.
I would then ask Erasistratus himself to inform me what the
altering, coagulating, and shaping agent is. He would doubtless
say, "Either Nature or the semen," meaning the same thing in both
cases, but explaining it by different devices. For that which was
previously semen, when it begins to procreate and to shape the
animal, becomes, so to say, a special nature. For in the same way
that Phidias possessed the faculties of his art even before
touching his material, and then activated these in connection with
this material (for every faculty remains inoperative in the
absence of its proper material), so it is with the semen: its
faculties it possessed from the beginning, while its activities it
does not receive from its material, but it manifests them in
connection therewith.
And, of course, if it were to be overwhelmed with a great quantity
of blood, it would perish, while if it were to be entirely
deprived of blood it would remain inoperative and would not turn
into a nature. Therefore, in order that it may not perish, but may
become a nature in place of semen, there must be an afflux to it
of a little blood- or, rather, one should not say a little, but a
quantity commensurate with that of the semen. What is it then that
measures the quantity of this afflux? What prevents more from
coming? What ensures against a deficiency? What is this third
overseer of animal generation that we are to look for, which will
furnish the semen with a due amount of blood? What would
Erasistratus have said if he had been alive, and had been asked
this question? Obviously, the semen itself. This, in fact, is the
artificer analogous with Phidias, whilst the blood corresponds to
the statuary's wax.
Now, it is not for the wax to discover for itself how much of it
is required; that is the business of Phidias. Accordingly the
artificer will draw to itself as much blood as it needs. Here,
however, we must pay attention and take care not unwittingly to
credit the semen with reason and intelligence; if we were to do
this, we would be making neither semen nor a nature, but an actual
living animal. And if we retain these two principles- that of
proportionate attraction and that of the non-participation of
intelligence- we shall ascribe to the semen a faculty for
attracting blood similar to that possessed by the lodestone for
iron. Here, then, again, in the case of the semen, as in so many
previous instances, we have been compelled to acknowledge some
kind of attractive faculty.
And what is the semen? Clearly the active principle of the animal,
the material principle being the menstrual blood. Next, seeing
that the active principle employs this faculty primarily,
therefore, in order that any one of the things fashioned by it may
come into existence, it [the principle] must necessarily be
possessed of its own faculty. How, then, was Erasistratus unaware
of it, if the primary function of the semen be to draw to itself a
due proportion of blood? Now, this fluid would be in due
proportion if it were so thin and vaporous, that, as soon as it
was drawn like dew into every part of the semen, it would
everywhere cease to display its own particular character; for so
the semen will easily dominate and quickly assimilate it- in fact,
will use it as food. It will then, I imagine, draw to itself a
second and a third quantum, and thus by feeding it acquires for
itself considerable bulk and quantity. In fact, the alterative
faculty has now been discovered as well, although about this also
has not written a word. And, thirdly the shaping faculty will
become evident, by virtue of which the semen firstly surrounds
itself with a thin membrane like a kind of superficial
condensation; this is what was described by Hippocrates in the
sixth-day birth, which, according to his statement, fell from the
singing-girl and resembled the pellicle of an egg. And following
this all the other stages will occur, such as are described by him
in his work "On the Child's Nature."
But if each of the parts formed were to remain as small as when it
first came into existence, of what use would that be? They have,
then, to grow. Now, how will they grow? By becoming extended in
all directions and at the same time receiving nourishment. And if
you will recall what I previously said about the bladder which the
children blew up and rubbed, you will also understand my meaning
better as expressed in what I am now about to say.
Imagine the heart to be, at the beginning, so small as to differ
in no respect from a millet-seed, or, if you will, a bean; and
consider how otherwise it is to become large than by being
extended in all directions and acquiring nourishment throughout
its whole substance, in the way that, as I showed a short while
ago, the semen is nourished. But even this was unknown to
Erasistratus- the man who sings the artistic skill of Nature! He
imagines that animals grow like webs, ropes, sacks, or baskets,
each of which has, woven on to its end or margin, other material
similar to that of which it was originally composed.
But this, most sapient sir, is not growth, but genesis! For a bag,
sack, garment, house, ship, or the like is said to be still coming
into existence [undergoing genesis] so long as the appropriate
form for the sake of which it is being constructed by the
artificer is still incomplete. Then, when does it grow? Only when
the basket, being complete, with a bottom, a mouth, and a belly,
as it were, as well as the intermediate parts, now becomes larger
in all these respects. "And how can this happen?" someone will
ask. Only by our basket suddenly becoming an animal or a plant;
for growth belongs to living things alone. Possibly you imagine
that a house grows when it is being built, or a basket when being
plated, or a garment when being woven? It is not so, however.
Growth belongs to that which has already been completed in respect
to its form, whereas the process by which that which is still
becoming attains its form is termed not growth but genesis. That
which is, grows, while that which is not, becomes.
4. This also was unknown to Erasistratus, whom nothing escaped, if
his followers speak in any way truly in maintaining that he was
familiar with the Peripatetic philosophers. Now, in so far as he
acclaims Nature as being an artist in construction, even I
recognize the Peripatetic teachings, but in other respects he does
not come near them. For if anyone will make himself acquainted
with the writings of Aristotle and Theophrastus, these will appear
to him to consist of commentaries on the Nature-lore [physiology]
of Hippocrates- according to which the principles of heat, cold,
dryness and moisture act upon and are acted upon by one another,
the hot principle being the most active, and the cold coming next
to it in power; all this was stated in the first place by
Hippocrates and secondly by Aristotle. Further, it is at once the
Hippocratic and the Aristotelian teaching that the parts which
receive that nourishment throughout their whole substance, and
that, similarly, processes of mingling and alteration involve the
entire substance. Moreover, that digestion is a species of
alteration- a transmutation of the nutriment into the proper
quality of the thing receiving it; that blood-production also is
an alteration, and nutrition as well; that growth results from
extension in all directions, combined with nutrition; that
alteration is effected mainly by the warm principle, and that
therefore digestion, nutrition, and the generation of the various
humours, as well as the qualities of the surplus substances,
result from the innate heat; all these and many other points
besides in regard to the aforesaid faculties, the origin of
diseases, and the discovery of remedies, were correctly stated
first by Hippocrates of all writers whom we know, and were in the
second place correctly expounded by Aristotle. Now, if all these
views meet with the approval of the Peripatetics, as they
undoubtedly do, and if none of them satisfy Erasistratus, what can
the Erasistrateans possibly mean by claiming that their leader was
associated with these philosophers? The fact is, they revere him
as a god, and think that everything he says is true. If this be
so, then we must suppose the Peripatetics to have strayed very far
from truth, since they approve of none of the ideas of
Erasistratus. And, indeed, the disciples of the latter produce his
connection with the Peripatetics in order to furnish his
Nature-lore with a respectable pedigree.
Now, let us reverse our argument and put it in a different way
from that which we have just employed. For if the Peripatetics
were correct in their teaching about Nature, there could be
nothing more absurd than the contentions of Erasistratus. And, I
will leave it to the Erasistrateans themselves to decide; they
must either advance the one proposition or the other. According to
the former one the Peripatetics had no accurate acquaintance with
Nature, and according to the second, Erasistratus. It is my task,
then, to point out the opposition between the two doctrines, and
theirs to make the choice....
But they certainly will not abandon their reverence for
Erasistratus. Very well, then; let them stop talking about the
Peripatetic philosophers. For among the numerous physiological
teachings regarding the genesis and destruction of animals, their
health, their diseases, and the methods of treating these, there
will be found one only which is common to Erasistratus and the
Peripatetics- namely, the view that Nature does everything for
some purpose, and nothing in vain.
But even as regards this doctrine their agreement is only verbal;
in practice Erasistratus makes havoc of it a thousand times over.
For, according to him, the spleen was made for no purpose, as also
the omentum; similarly, too, the arteries which are inserted into
kidneys- although these are practically the largest of all those
that spring from the great artery [aorta]! And to judge by the
Erasistratean argument, there must be countless other useless
structures; for, if he knows nothing at all about these
structures, he has little more anatomical knowledge than a
butcher, while, if he is acquainted with them and yet does not
state their use, he clearly imagines that they were made for no
purpose, like the spleen. Why, however, should I discuss these
structures fully, belonging as they do to the treatise "On the Use
of Parts," which I am personally about to complete?
Let us, then, sum up again this same argument, and, having said a
few words more in answer to the Erasistrateans, proceed to our
next topic. The fact is, these people seem to me to have read none
of Aristotle's writings, but to have heard from others how great
an authority he was on "Nature," and that those of the Porch
follow in the steps of his Nature-lore; apparently they then
discovered a single one of the current ideas which is common to
Aristotle and Erasistratus, and made up some story of a connection
between Erasistratus and these people. That Erasistratus, however,
has no share in the Nature-lore of Aristotle is shown by an
enumeration of the aforesaid doctrines, which emanated first from
Hippocrates, secondly from Aristotle, thirdly from the Stoics
(with a single modification, namely, that for them the qualities
are bodies). Perhaps, however, they will maintain that it was in
the matter of logic that Erasistratus associated himself with the
Peripatetic philosophers? Here they show ignorance of the fact
that these philosophers never brought forward false or
inconclusive arguments, while the Erasistratean books are full of
them.
So perhaps somebody may already be asking, in some surprise, what
possessed Erasistratus that he turned so completely from the
doctrines of Hippocrates, and why it is that he takes away the
attractive faculty from the biliary passages in the liver- for we
have sufficiently discussed the kidneys- alleging [as the cause of
bile-secretion] a favourable situation, the narrowness of vessels,
and a common space into which the veins from the gateway [of the
liver] conduct the unpurified blood, and from which, in the first
place, the [biliary] passages take over the bile, and secondly,
the [branches] of the vena cava take over the purified blood. For
it would not only have done him no harm to have mentioned the idea
of attraction, but he would thereby have been able to get rid of
countless other disputed questions.
5. At the actual moment, however, the Erasistrateans are engaged
in a considerable battle, not only with others but also amongst
themselves, and so they cannot explain the passage from the first
book of the "General Principles," in which Erasistratus says,
"Since there are two kinds of vessels opening at the same place,
the one kind extending to the gall-bladder and the other to the
vena cava, the result is that, of the nutriment carried up from
the alimentary canal, that part which fits both kinds of stomata
is received into both kinds of vessels, some being carried into
the gall-bladder, and the rest passing over into the vena cava."
For it is difficult to say what we are to understand by the words
"opening at the same place" which are written at the beginning of
this passage. Either they mean there is a junction between the
termination of the vein which is on the concave surface of the
liver and two other vascular terminations (that of the vessel on
the convex surface of the liver and that of the bile-duct), or, if
not, then we must suppose that there is, as it were, a common
space for all three vessels, which becomes filled from the lower
vein, and empties itself both into the bile-duct and into the
branches of the vena cava. Now, there are many difficulties in
both of these explanations, but if I were to state them all, I
should find myself inadvertently writing an exposition of the
teaching of Erasistratus, instead of carrying out my original
undertaking. There is, however, one difficulty common to both
these explanations, namely, that the whole of the blood does not
become purified. For it ought to fall into the bile-duct as into a
kind of sieve, instead of going (running, in fact, rapidly) past
it, into the larger stoma, by virtue of the impulse of anadosis.
Are these, then, the only inevitable difficulties in which the
argument of Erasistratus becomes involved through his
disinclination to make any use of the attractive faculty, or is it
that the difficulty is greatest here, and also so obvious that
even a child could not avoid seeing it?
6. And if one looks carefully into the matter one will find that
even Erasistratus' reasoning on the subject of nutrition, which he
takes up in the second book of his "General Principles," fails to
escape this same difficulty. For, having conceded one premise to
the principle that matter tends to fill a vacuum, as we previously
showed, he was only able to draw a conclusion in the case of the
veins and their contained blood. That is to say, when blood is
running away through the stomata of the veins, and is being
dispersed, then, since an absolutely empty space cannot result,
and the veins cannot collapse (for this was what he overlooked),
it was therefore shown to be necessary that the that the adjoining
quantum of fluid should flow in and fill the place of the fluid
evacuated. It is in this way that we may suppose the veins to be
nourished; they get the benefit of the blood which they contain.
But how about the nerves? For they do not also contain blood. One
might obviously say that they draw their supply from the veins.
But Erasistratus will not have it so. What further contrivance,
then, does he suppose? He says that a nerve has within itself
veins and arteries, like a rope woven by Nature out of three
different strands. By means of this hypothesis he imagined that
his theory would escape from the idea of attraction. For if the
nerve contain within itself a blood-vessel it will no longer need
the adventitious flow of other blood from the real vein lying
adjacent; this fictitious vessel, perceptible only in theory, will
suffice it for nourishment.
But this, again, is succeeded by another similar difficulty. For
this small vessel will nourish itself, but it will not be able to
nourish this adjacent simple nerve or artery, unless these possess
some innate proclivity for attracting nutriment. For how could the
nerve, being simple, attract its nourishment, as do the composite
veins, by virtue of the tendency of a vacuum to become refilled?
For, although according to Erasistratus, it contains within itself
a cavity of sorts, this is not occupied with blood, but with
psychic pneuma, and we are required to imagine the nutriment
introduced, not into this cavity, but into the vessel containing
it, whether it needs merely to be nourished, or to grow as well.
How, then, are we to imagine it introduced? For this simple vessel
[i.e. nerve] is so small- as are also the other two- that if you
prick it at any part with the finest needle you will tear the
whole three of them at once. Thus there could never be in it a
perceptible space entirely empty. And an emptied space which
merely existed in theory could not compel the adjacent fluid to
come and fill it.
At this point, again, I should like Erasistratus himself to answer
regarding this small elementary nerve, whether it is actually one
and definitely continuous, or whether it consists of many small
bodies, such as those assumed by Epicurus, Leucippus, and
Democritus. For I see that the Erasistrateans are at variance on
this subject. Some of them consider it one and continuous, for
otherwise, as they say, he would not have called it simple; and
some venture to resolve it into yet other elementary bodies. But
if it be one and continuous, then what is evacuated from it in the
so-called insensible transpiration of the physicians will leave no
empty space in it; otherwise it would not be one body but many,
separated by empty spaces. But if it consists of many bodies, then
we have "escaped by the back door," as the saying is, to
Asclepiades, seeing that we have postulated certain inharmonious
elements. Once again, then, we must call Nature "inartistic"; for
this necessarily follows the assumption of such elements.
For this reason some of the Erasistrateans seem to me to have done
very foolishly in reducing the simple vessels to elements such as
these. Yet it makes no difference to me, since the theory of both
parties regarding nutrition will be shown to be absurd. For in
these minute simple vessels constituting the large perceptible
nerves, it is impossible, according to the theory of those who
would keep the former continuous, that any "refilling of a vacuum"
should take place, since no vacuum can occur in a continuum even
if anything does run away; for the parts left come together (as is
seen in the case of water) and again become one, taking up the
whole space of that which previously separated them. Nor will any
"refilling" occur if we accept the argument of the other
Erasistrateans, since none of their elements need it. For this
principle only holds of things which are perceptible, and not of
those which exist merely in theory; this Erasistratus expressly
acknowledges, for he states that it is not a vacuum such as this,
interspersed in small portions among the corpuscles, that his
various treatises deal with, but a vacuum which is clear,
perceptible, complete in itself, large in size, evident, or
however else one cares to term it (for, what Erasistratus himself
says is, that "there cannot be a perceptible space which is
entirely empty"; while I, for my part, being abundantly equipped
with terms which are equally elucidatory, at least in relation to
the present topic of discussion, have added them as well).
Thus it seems to me better that we also should help the
Erasistrateans with some contribution, since we are on the
subject, and should advise those who reduce the vessel called
primary and simple by Erasistratus into other elementary bodies to
give up their opinion; for not only do they gain nothing by it,
but they are also at variance with Erasistratus in this matter.
That they gain nothing by it has been clearly demonstrated; for
this hypothesis could not escape the difficulty regarding
nutrition. And it also seems perfectly evident to me that this
hypothesis is not in consonance with the view of Erasistratus,
when it declares that what he calls simple and primary is
composite, and when it destroys the principle of Nature's artistic
skill. For, if we do not grant a certain unity of substance to
these simple structures as well, and if we arrive eventually at
inharmonious and indivisible elements, we shall most assuredly
deprive Nature of her artistic skill, as do all the physicians and
philosophers who start from this hypothesis. For, according to
such a hypothesis, Nature does not precede, but is secondary to
the parts of the animal. Now, it is not the province of what comes
secondarily, but of what pre-exists, to shape and to construct.
Thus we must necessarily suppose that the faculties of Nature, by
which she shapes the animal, and makes it grow and receive
nourishment, are present from the seed onwards; whereas none of
these inharmonious and non-partite corpuscles contains within
itself any formative, incremental, nutritive, or, in a word, any
artistic power; it is, by hypothesis, unimpressionable and
untransformable, whereas, as we have previously shown, none of the
processes mentioned takes place without transformation,
alteration, and complete intermixture. And, owing to this
necessity, those who belong to these sects are unable to follow
out the consequences of their supposed elements, and they are all
therefore forced to declare Nature devoid of art. It is not from
us, however, that the Erasistrateans should have learnt this, but
from those very philosophers who lay most stress on a preliminary
investigation into the elements of all existing things.
Now, one can hardly be right in supposing that Erasistratus could
reach such a pitch of foolishness as to be recognizing the logical
consequences of this theory, and that, while assuming Nature to be
artistically creative, he would at the same time break up
substance into insensible, inharmonious, and untransformable
elements. If, however, he will grant that there occurs in the
elements a process of alteration and transformation, and that
there exists in them unity and continuity, then that simple vessel
of his (as he himself names it) will turn out to be single and
uncompounded. And the simple vein will receive nourishment from
itself, and the nerve and artery from the vein. How, and in what
way? For, when we were at this point before, we drew attention to
the disagreement among the Erasistrateans, and we showed that the
nutrition of these simple vessels was impraticable according to
the teachings of both parties, although we did not hesitate to
adjudicate in their quarrel and to do Erasistratus the honour of
placing him in the better sect.
Let our argument, then, be transferred again to the doctrine which
assumes this elementary nerve to be a single, simple, and entirely
unified structure, and let us consider how it is to be nourished;
for what is discovered here will at once be found to be common
also to the school of Hippocrates.
It seems to me that our enquiry can be most rigorously pursued in
subjects who are suffering from illness and have become very
emaciated, since in these people all parts of the body are
obviously atrophied and thin, and in need of additional substance
and feeding-up; for the same reason the ordinary perceptible
nerve, regarding which we originally began this discussion, has
become thin, and requires nourishment. Now, this contains within
itself various parts, namely, a great many of these primary,
invisible, minute nerves, a few simple arteries, and similarly
also veins. Thus, all its elementary nerves have themselves also
obviously become emaciated; for, if they had not, neither would
the nerve as a whole; and of course, in such a case, the whole
nerve cannot require nourishment without each of these requiring
it too. Now, if on the one hand they stand in need of feeding-up,
and if on the other the principle of the refilling of a vacuum can
give them no help- both by reason of the difficulties previously
mentioned and the actual thinness, as I shall show- we must then
seek another cause for nutrition.
How is it, then, that the tendency of a vacuum to become refilled
is unable to afford nourishment to one in such a condition?
Because its rule is that only so much of the contiguous matter
should succeed as has flowed away. Now this is sufficient for
nourishment in the case of those who are in good condition, for,
in them, what is presented must be equal to what has flowed away.
But in the case of those who are very emaciated and who need a
great restoration of nutrition, unless what was presented were
many times greater than what has been emptied out, they would
never be able to regain their original habit. It is clear,
therefore, that these parts will have to exert a greater amount of
attraction, in so far as their requirements are greater. And I
fail to understand how Erasistratus does not perceive that here
again he is putting the cart before the horse. Because, in the
case of the sick, there must be a large amount of presentation in
order to feed them up, he argues that the factor of "refilling"
must play an equally large part. And how could much presentation
take place if it were not preceded by an abundant delivery of
nutriment? And if he calls the conveyance of food through the
veins delivery, and its assumption by each of these simple and
visible nerves and arteries not delivery but distribution, as some
people have thought fit to name it, and then ascribes conveyance
through the veins to the principle of vacuum refilling alone, let
him explain to us the assumption of food by the hypothetical
elements. For it has been shown that at least in relation to these
there is no question of the refilling of a vacuum being in
operation, and especially where the parts are very attenuated. It
is worth while listening to what Erasistratus says about these
cases in the second book of his "General Principles": "In the
ultimate simple [vessels], which are thin and narrow, presentation
takes place from the adjacent vessels, the nutriment being
attracted through the sides of the vessels and deposited in the
empty spaces left by the matter which has been carried away." Now,
in this statement firstly I admit and accept the words "through
the sides." For, if the simple nerve were actually to take in the
food through its mouth, it could not distribute it through its
whole substance; for the mouth is dedicated to the psychic pneuma.
It can, however, take it in through its sides from the adjacent
simple vein. Secondly, I also accept in Erasistratus' statement
the expression which precedes "through the sides." What does this
say? "The nutriment being attracted through the sides of the
vessels." Now I, too, agree that it is attracted, but it has been
previously shown that this is not through the tendency of
evacuated matter to be replaced.
7. Let us, then, consider together how it is attracted. How else
than in the way that iron is attracted by the lodestone, the
latter having a faculty attractive of this particular quality
[existing in iron]? But if the beginning of anadosis depends on
the squeezing action of the stomach, and the whole movement
thereafter on the peristalsis and propulsive action of the veins,
as well as on the traction exerted by each of the parts which are
undergoing nourishment, then we can abandon the principle of
replacement of evacuated matter, as not being suitable for a man
who assumes Nature to be a skilled artist; thus we shall also have
avoided the contradiction of Asclepiades though we cannot refute
it: for the disjunctive argument used for the purposes of
demonstration is, in reality, disjunctive not of two but of three
alternatives; now, if we treat the disjunction as a disjunction of
two alternatives, one of the two propositions assumed in
constructing our proof must be false; and if as a disjunctive of
three alternatives, no conclusion will be arrived at.
8. Now Erasistratus ought not to have been ignorant of this if he
had ever had anything to do with the Peripatetics- even in a
dream. Nor, similarly, should he have been unacquainted with the
genesis of the humours, about which, not having even anything
moderately plausible to say, he thinks to deceive us by the excuse
that the consideration of such matters is not the least useful.
Then, in Heaven's name, is it useful to know how food is digested
in the stomach, but unnecessary to know how bile comes into
existence in the veins? Are we to pay attention merely to the
evacuation of this humour, and not to its genesis? As though it
were not far better to prevent its excessive development from the
beginning than to give ourselves all the trouble of expelling it!
And it is a strange thing to be entirely unaware as to whether its
genesis is to be looked on as taking place in the body, or whether
it comes from without and is contained in the food. For, if it was
right to raise this problem, why should we not make investigations
concerning the blood as well- whether it takes its origin in the
body, or is distributed through the food as is maintained by those
who postulate homoeomeries? Assuredly it would be much more useful
to investigate what kinds of food are suited, and what kinds
unsuited, to the process of blood-production rather than to
enquire into what articles of diet are easily mastered by the
activity of the stomach, and what resist and contend with it. For
the choice of the latter bears reference merely to digestion,
while that of the former is of importance in regard to the
generation of useful blood. For it is not equally important
whether the aliment be imperfectly chylified in the stomach or
whether it fail to be turned into useful blood. Why is
Erasistratus not ashamed to distinguish all the various kinds of
digestive failure and all the occasions which give rise to them,
whilst in reference to the errors of blood-production he does not
utter a single word- nay, not a syllable? Now, there is certainly
to be found in the veins both thick and thin blood; in some people
it is redder, in others yellower, in some blacker, in others more
of the nature of phlegm. And one who realizes that it may smell
offensively not in one way only, but in a great many different
respects (which cannot be put into words, although perfectly
appreciable to the senses), would, I imagine, condemn in no
measured terms the carelessness of Erasistratus in omitting a
consideration so essential to the practice of our art.
Thus it is clear what errors in regard to the subject of dropsies
logically follow this carelessness. For, does it not show the most
extreme carelessness to suppose that the blood is prevented from
going forward into the liver owing to the narrowness of the
passages, and that dropsy can never occur in any other way? For,
to imagine that dropsy is never caused by the spleen or any other
part, but always by induration of the liver, is the standpoint of
a man whose intelligence is perfectly torpid and who is quite out
of touch with things that happen every day. For, not merely once
or twice, but frequently, we have observed dropsy produced by
chronic haemorrhoids which have been suppressed, or which, through
immoderate bleeding, have given the patient a severe chill;
similarly, in women, the complete disappearance of the monthly
discharge, or an undue evacuation such as is caused by violent
bleeding from the womb, often provoke dropsy; and in some of them
the so-called female flux ends in this disorder. I leave out of
account the dropsy which begins in the flanks or in any other
susceptible part; this clearly confutes Erasistratus' assumption,
although not so obviously as does that kind of dropsy which is
brought about by an excessive chilling of the whole constitution;
this, which is the primary reason for the occurrence of dropsy,
results from a failure of blood-production, very much like the
diarrhoea which follows imperfect digestion of food; certainly in
this kind of dropsy neither the liver nor any other viscus becomes
indurated.
The learned Erasistratus, however, overlooks- nay, despises- what
neither Hippocrates, Diocles, Praxagoras, nor indeed any of the
best philosophers, whether Plato, Aristotle, or Theophrastus; he
passes by whole functions as though it were but a trifling and
casual department of medicine which he was neglecting, without
deigning to argue whether or not these authorities are right in
saying that the bodily parts of all animals are governed by the
Warm, the Cold, the Dry and the Moist, the one pair being active
the other passive, and that among these the Warm has most power in
connection with all functions, but especially with the genesis of
the humours. Now, one cannot be blamed for not agreeing with all
these great men, nor for imagining that one knows more than they;
but not to consider such distinguished teaching worthy either of
contradiction or even mention shows an extraordinary arrogance.
Now, Erasistratus is thoroughly small-minded and petty to the last
degree in all his disputations- when, for instance, in his
treatise "On Digestion," he argues jealously with those who
consider that this is a process of putrefaction of the food; and,
in his work "On Anadosis," with those who think that the anadosis
of blood through the veins results from the contiguity of the
arteries; also, in his work "On Respiration," with those who
maintain that the air is forced along by contraction. Nay, he did
not even hesitate to contradict those who maintain that the urine
passes into the bladder in a vaporous state, as also those who say
that imbibed fluids are carried into the lung. Thus he delights to
choose always the most valueless doctrines, and to spend his time
more and more in contradicting these; whereas on the subject of
the origin of blood (which is in no way less important than the
chylification of food in the stomach) he did not deign to dispute
with any of the ancients, nor did he himself venture to bring
forward any other opinion, despite the fact that at the beginning
of his treatise on "General Principles" he undertook to say how
all the various natural functions take place, and through what
parts of the animal! Now, is it possible that, when the faculty
which naturally digests food is weak, the animal's digestion
fails, whereas the faculty which turns the digested food into
blood cannot suffer any kind of impairment? Are we to suppose this
latter faculty alone to be as tough as steel and unaffected by
circumstances? Or is it that weakness of this faculty will result
in something else than dropsy? The fact, therefore, that
Erasistratus, in regard to other matters, did not hesitate to
attack even the most trivial views, whilst in this he neither
dared to contradict his predecessors nor to advance any new view
of his own, proves plainly that he recognized the fallacy of his
own way of thinking.
For what could a man possibly say about blood who had no use for
innate heat? What could he say about yellow or black bile, or
phlegm? Well, of course, he might say that the bile could come
directly from without, mingled with the food! Thus Erasistratus
practically says so in the following words: "It is of no value in
practical medicine to find out whether fluid of this kind arises
from the elaboration of food in the stomach-region, or whether it
reaches the body because it is mixed with the food taken in from
outside." But my very good Sir, you most certainly maintain also
that this humour has to be evacuated from the animal, and that it
causes great pain if it be not evacuated. How, then, if you
suppose that no good comes from the bile, do you venture to say
that an investigation into its origin is of no value in medicine?
Well, let us suppose that it is contained in the food, and not
specifically secreted in the liver (for you hold these two things
possible). In this case, it will certainly make a considerable
difference whether the ingested food contains a minimum or a
maximum of bile; for the one kind is harmless, whereas that
containing a large quantity of bile, owing to the fact that it
cannot be properly purified in the liver, will result in the
various affections- particularly jaundice- which Erasistratus
himself states to occur where there is much bile. Surely, then, it
is most essential for the physician to know in the first place,
that the bile is contained in the food itself from outside, and,
secondly, that for example, beet contains a great deal of bile,
and bread very little, while olive oil contains most, and wine
least of all, and all the other articles of diet different
quantities. Would it not be absurd for any one to choose
voluntarily those articles which contain more bile, rather than
those containing less?
What, however, if the bile is not contained in the food, but comes
into existence in the animal's body? Will it not also be useful to
know what state of the body is followed by a greater, and what by
a smaller occurrence of bile? For obviously it is in our power to
alter and transmute morbid states of the body- in fact, to give
them a turn for the better. But if we did not know in what respect
they were morbid or in what way they diverged from the normal, how
should we be able to ameliorate them?
Therefore it is not useless in treatment, as Erasistratus says, to
know the actual truth about the genesis of bile. Certainly it is
not impossible, or even difficult to discover that the reason why
honey produces yellow bile is not that it contains a large
quantity of this within itself, but because it [the honey]
undergoes change, becoming altered and transmuted into bile. For
it would be bitter to the taste if it contained bile from the
outset, and it would produce an equal quantity of bile in every
person who took it. The facts, however, are not so. For in those
who are in the prime of life, especially if they are warm by
nature and are leading a life of toil, the honey changes entirely
into yellow bile. Old people, however, it suits well enough,
inasmuch as the alteration which it undergoes is not into bile,
but into blood. Erasistratus, however, in addition to knowing
nothing about this, shows no intelligence even in the division of
his argument; he says that it is of no practical importance to
investigate whether the bile is contained in the food from the
beginning or comes into existence as a result of gastric
digestion. He ought surely to have added something about its
genesis in liver and veins, seeing that the old physicians and
philosophers declare that it along with the blood is generated in
these organs. But it is inevitable that people who, from the very
outset, go astray, and wander from the right road, should talk
such nonsense, and should, over and above this, neglect to search
for the factors of most practical importance in medicine.
Having come to this poi in the argument, I should like to ask
those who declare that Erasistratus was very familiar with the
Peripatetics, whether they know what Aristotle stated and
demonstrated with regard to our bodies being compounded out of the
Warm, the Cold, the Dry and the Moist, and how he says that among
these the Warm is the most active, and that those animals which
are by nature warmest have abundance of blood, whilst those that
are colder are entirely lacking in blood, and consequently in
winter lie idle and motionless, lurking in holes like corpses.
Further, the question of the colour of the blood has been dealt
with not only by Aristotle but also by Plato. Now I, for my part,
as I have already said, did not set before myself the task of
stating what has been so well demonstrated by the Ancients, since
I cannot surpass these men either in my views or in my method of
giving them expression. Doctrines, however, which they either
stated without demonstration, as being self-evident (since they
never suspected that there could be sophists so degraded as to
contemn the truth in these matters), or else which they actually
omitted to mention at all- these I propose to discover and prove.
Now in reference to the genesis of the humours, I do not know that
any one could add anything wiser than what has been said by
Hippocrates, Aristotle, Praxagoras, Philotimus and many other
among the Ancients. These men demonstrated that when the nutriment
becomes altered in the veins by the innate heat, blood is produced
when it is in moderation, and the other humours when it is not in
proper proportion. And all the observed facts agree with this
argument. Thus, those articles of food, which are by nature warmer
are more productive of bile, while those which are colder produce
more phlegm. Similarly of the periods of life, those which are
naturally warmer tend more to bile, and the colder more to phlegm.
Of occupations also, localities and seasons, and, above all, of
natures themselves, the colder are more phlegmatic, and the warmer
more bilious. Also cold diseases result from and warmer ones from
yellow bile. There is not a single thing to be found which does
not bear witness to the truth of this account. How could it be
otherwise? For, seeing that every part functions in its own
special way because of the manner in which the four qualities are
compounded, it is absolutely necessary that the function
[activity] should be either completely destroyed, or, at least
hampered, by any damage to the qualities, and that thus the animal
should fall ill, either as a whole, or in certain of its parts.
Also the diseases which are primary and most generic are four in
number, and differ from each other in warmth, cold, dryness and
moisture. Now, Erasistratus himself confesses this, albeit
unintentionally; for when he says that the digestion of food
becomes worse in fever, not because the innate heat has ceased to
be in due proportion, as people previously supposed, but because
the stomach, with its activity impaired, cannot contract and
triturate as before- then, I say, one may justly ask him what it
is that has impaired the activity of the stomach.
Thus, for example, when a bubo develops following an accidental
wound gastric digestion does not become impaired until the patient
has become fevered; neither the bubo nor the sore of itself
impedes in any way or damages the activity of the stomach. But if
fever occurs, the digestion at once deteriorates, and we are also
right in saying that the activity of the stomach at once becomes
impaired. We must add, however, by what it has been impaired. For
the wound was not capable of impairing it, nor yet the bubo, for,
if they had been, then they would have caused this damage before
the fever as well. If it was not these that caused it, then it was
the excess of heat (for these two symptoms occurred besides the
bubo- an alteration in the arterial and cardiac movements and an
excessive development of natural heat). Now the alteration of
these movements will not merely not impair the function of the
stomach in any way: it will actually prove an additional help
among those animals in which, according to Erasistratus, the
pneuma, which is propelled through the arteries and into the
alimentary canal, is of great service in digestion; there is only
left, then, the disproportionate heat to account for the damage to
the gastric activity. For the pneuma is driven in more vigorously
and continuously, and in greater quantity now than before; thus in
this case, the animal whose digestion is promoted by pneuma will
digest more, whereas the remaining factor- abnormal heat- will
give them indigestion. For to say, on the one hand, that the
pneuma has a certain property by virtue of which it promotes
digestion, and then to say that this property disappears in cases
of fever, is simply to admit the absurdity. For when they are
again asked what it is that has altered the pneuma, they will only
be able to reply, "the abnormal heat," and particularly if it be
the pneuma in the food canal which is in question (since this does
not come in any way near the bubo).
Yet why do I mention those animals in which the property of the
pneuma plays an important part, when it is possible to base one's
argument upon human beings, in whom it is either of no importance
at all, or acts quite faintly and feebly? But Erasistratus himself
agrees that human beings digest badly in fevers, adding as the
cause that the activity of the stomach has been impaired. He
cannot, however, advance any other cause of this impairment than
abnormal heat. But if it is not by accident that the abnormal heat
impairs this activity, but by virtue of its own essence and power,
then this abnormal heat must belong to the primary diseases. But,
indeed, if disproportion of heat belongs to the primary diseases,
it cannot but be that a proportionate blending [eucrasia] of the
qualities produces the normal activity. For a disproportionate
blend [dyscrasia] can only become a cause of the primary diseases
through derangement of the eucrasia. That is to say, it is because
the [normal] activities arise from the eucrasia that the primary
impairments of these activities necessarily arise the from
derangement.
I think, then, it has been proved to the satisfaction of those who
are capable of seeing logical consequences, that, even according
to Erasistratus' own argument, the cause of the normal functions
is eucrasia of the Warm. Now, this being so, there is nothing
further to prevent us from saying that, in the case of each
function, eucrasia is followed by the more, and dyscrasia by the
less favourable alternative. And, therefore, if this be the case,
we must suppose blood to be the outcome of proportionate, and
yellow bile of disproportionate heat. So we naturally find yellow
bile appearing in greatest quantity in ourselves at the warm
periods of life, in warm countries, at warm seasons of the year,
and when we are in a warm condition; similarly in people of warm
temperaments, and in connection with warm occupations, modes of
life, or diseases.
And to be in doubt as to whether this humour has the genesis in
the human body or is contained in the food is what you would
expect from one who has- I will not say failed to see that, when
those who are perfectly healthy have, under the compulsion of
circumstances, to fast contrary to custom, their mouths become
bitter and their urine bile-coloured, while they suffer from
gnawing pains in the stomach- but has, as it were, just made a
sudden entrance into the world, and is not yet familiar with the
phenomena which occur there. Who, in fact, does not know that
anything which is overcooked grows at first salt and afterwards
bitter? And if you will boil honey itself, far the sweetest of all
things, you can demonstrate that even this becomes quite bitter.
For what may occur as a result of boiling in the case of other
articles which are not warm by nature, exists naturally in honey;
for this reason it does not become sweeter on being boiled, since
exactly the same quantity of heat as is needed for the production
of sweetness exists from beforehand in the honey. Therefore the
external heat, which would be useful for insufficiently warm
substances, becomes in the honey a source of damage, in fact an
excess; and it is for this reason that honey, when boiled, can be
demonstrated to become bitter sooner than the others. For the same
reason it is easily transmuted into bile in those people who are
naturally warm, or in their prime, since warm when associated with
warm becomes readily changed into a disproportionate combination
and turns into bile sooner than into blood. Thus we need a cold
temperament and a cold period of life if we would have honey
brought to the nature of blood. Therefore Hippocrates not
improperly advised those who were naturally bilious not to take
honey, since they were obviously of too warm a temperament. So
also, not only Hippocrates, but all physicians say that honey is
bad in bilious diseases but good in old age; some of them having
discovered this through the indications afforded by its nature,
and others simply through experiment, for the Empiricist
physicians too have made precisely the same observation, namely,
that honey is good for an old man and not for a young one, that it
is harmful for those who are naturally bilious, and serviceable
for those who are phlegmatic. In a word, in bodies which are warm
either through nature, disease, time of life, season of the year,
locality, or occupation, honey is productive of bile, whereas in
opposite circumstances it produces blood.
But surely it is impossible that the same article of diet can
produce in certain persons bile and in others blood, if it be not
that the genesis of these humours is accomplished in the body. For
if all articles of food contained bile from the beginning and of
themselves, and did not produce it by undergoing change in the
animal body, then they would produce it similarly in all bodies;
the food which was bitter to the taste would, I take it, be
productive of bile, while that which tasted good and sweet would
not generate even the smallest quantity of bile. Moreover, not
only honey but all other sweet substances are readily converted
into bile in the aforesaid bodies which are warm for any of the
reasons mentioned.
Well, I have somehow or other been led into this discussion,- not
in accordance with my plan, but compelled by the course of the
argument. This subject has been treated at great length by
Aristotle and Praxagoras, who have correctly expounded the view of
Hippocrates and Plato.
9. For this reason the things that we have said are not to be
looked upon as proofs but rather as indications of the dulness of
those who think differently, and who do not even recognise what is
agreed on by everyone and is a matter of daily observation. As for
the scientific proofs of all this, they are to be drawn from these
principles of which I have already spoken- namely, that bodies act
upon and are acted upon by each other in virtue of the Warm, Cold,
Moist and Dry. And if one is speaking of any activity, whether it
be exercised by vein, liver, arteries, heart, alimentary canal, or
any part, one will be inevitably compelled to acknowledge that
this activity depends upon the way in which the four qualities are
blended. Thus I should like to ask the Erasistrateans why it is
that the stomach contracts upon the food, and why the veins
generate blood. There is no use in recognizing the mere fact of
contraction, without also knowing the cause; if we know this, we
shall also be able to rectify the failures of function. "This is
no concern of ours," they say; "we do not occupy ourselves with
such causes as these; they are outside the sphere of the
practitioner, and belong to that of the scientific investigator."
Are you, then, going to oppose those who maintain that the cause
of the function of every organ is a natural eucrasia, that the
dyscrasia is itself known as a disease, and that it is certainly
by this that the activity becomes impaired? Or, on the other hand,
will you be convinced by the proofs which the ancient writers
furnished? Or will you take a midway course between these two,
neither perforce accepting these arguments as true nor
contradicting them as false, but suddenly becoming sceptics-
Pyrrhonists, in fact? But if you do this you will have to shelter
yourselves behind the Empiricist teaching. For how are you going
to be successful in treatment, if you do not understand the real
essence of each disease? Why, then, did you not call yourselves
Empiricists from the beginning? Why do you confuse us by
announcing that you are investigating natural activities with a
view to treatment? If the stomach is, in a particular case, unable
to exercise its peristaltic and grinding functions, how are we
going to bring it back to the normal if we do not know the cause
of its disability? What I say is that we must cool the over-heated
stomach and warm the warm the chilled one; so also we must moisten
the one which has become dried up, and conversely; so, too, in
combinations of these conditions; if the stomach becomes at the
same time warmer and drier than normally, the first principle of
treatment is at once to chill and moisten it; and if it become
colder and moister, it must be warmed and dried; so also in other
cases. But how on earth are the followers of Erasistratus going to
act, confessing as they do that they make no sort of investigation
into the cause of disease? For the fruit of the enquiry into
activities is that by knowing the causes of the dyscrasiae one may
bring them back to the normal, since it is of no use for the
purposes of treatment merely to know what the activity of each
organ is.
Now, it seems to me that Erasistratus is unaware of this fact
also, that the actual disease is that condition of the body which,
not accidentally, but primarily and of itself, impairs the normal
function. How, then, is he going to diagnose or cure diseases if
he is entirely ignorant of what they are, and of what kind and
number? As regards the stomach, certainly, Erasistratus held that
one should at least investigate how it digests the food. But why
was not investigation also made as to the primary originative
cause of this? And, as regards the veins and the blood, he omitted
even to ask the question "how?"
Yet neither Hippocrates nor any of the other physicians or
philosophers whom I mentioned a short while ago thought it right
to omit this; they say that when the heat which exists naturally
in every animal is well blended and moderately moist it generates
blood; for this reason they also say that the blood is a virtually
warm and moist humour, and similarly also that yellow bile is warm
and dry, even though for the most part it appears moist. (For in
them the apparently dry would seem to differ from the virtually
dry.) Who does not know that brine and sea-water preserve meat and
keep it uncorrupted, whilst all other water- the drinkable kind-
readily spoils and rots it? And who does not know that when yellow
bile is contained in large quantity in the stomach, we are
troubled with an unquenchable thirst, and that when we vomit this
up, we at once become much freer from thirst than if we had drunk
very large quantities of fluid? Therefore this humour has been
very properly termed warm, and also virtually dry. And, similarly,
phlegm has been called cold and moist; for about this also clear
proofs have been given by Hippocrates and the other Ancients.
Prodicus also, when in his book "On the Nature of Man" he gives
the name "phlegm" to that element in the humours which has been
burned or, as it were, over-roasted, while using a different
terminology, still keeps to the fact just as the others do; this
man's innovations in nomenclature have also been amply done
justice to by Plato. Thus, the white-coloured substance which
everyone else calls phlegm, and which Prodicus calls blenna
[mucus], is the well-known cold, moist humour which collects
mostly in old people and in those who have been chilled in some
way, and not even a lunatic could say that this was anything else
than cold and moist.
If, then, there is a warm and moist humour, and another which is
warm and dry, and yet another which is moist and cold, is there
none which is virtually cold and dry? Is the fourth combination of
temperaments, which exists in all other things, non-existent in
the humours alone? No; the black bile is such a humour. This,
according to intelligent physicians and philosophers, tends to be
in excess, as regards seasons, mainly in the fall of the year,
and, as regards ages, mainly after the prime of life. And,
similarly, also they say that there are cold and dry modes of
life, regions, constitutions, and diseases. Nature, they suppose,
is not defective in this single combination; like the three other
combinations, it extends everywhere.
At this point, also, I would gladly have been able to ask
Erasistratus whether his "artistic" Nature has not constructed any
organ for clearing away a humour such as this. For whilst there
are two organs for the excretion of urine, and another of
considerable size for that of yellow bile, does the humour which
is more pernicious than these wander about persistently in the
veins mingled with the blood? Yet Hippocrates says, "Dysentery is
a fatal condition if it proceeds from black bile"; while that
proceeding from yellow bile is by no means deadly, and most people
recover from it; this proves how much more pernicious and acrid in
its potentialities is black than yellow bile. Has Erasistratus,
then, not read the book, "On the Nature of Man," any more than any
of the rest of Hippocrates' writings, that he so carelessly passes
over the consideration of the humours? Or, does the know it, and
yet voluntarily neglect one of the finest studies in medicine?
Thus he ought not to have said anything about the spleen, nor have
stultified himself by holding that an artistic Nature would have
prepared so large an organ for no purpose. As a matter of fact,
not a matter of fact, not only Hippocrates and Plato- who are no
less authorities on Nature than is Erasistratus- say that this
viscus also is one of those which cleanse the blood, but there are
thousands of the ancient physicians and philosophers as well who
are in agreement with them. Now, all of these the high and mighty
Erasistratus affected to despise, and he neither contradicted them
nor even so much as mentioned their opinion. Hippocrates, indeed,
says that the spleen wastes in those people in whom the body is in
good condition, and all those physicians also who base themselves
on experience agree with this. Again, in those cases in which the
spleen is large and is increasing from internal suppuration, it
destroys the body and fills it with evil humours; this again is
agreed on, not only by Hippocrates, but also by Plato and many
others, including the Empiric physicians. And the jaundice which
occurs when the spleen is out of order is darker in colour, and
the cicatrices of ulcers are dark. For, generally speaking, when
the spleen is drawing the atrabiliary humour into itself to a less
degree than is proper, the blood is unpurified, and the whole body
takes on a bad colour. And when does it draw this in to a less
degree than proper? Obviously, when it [the spleen] is in a bad
condition. Thus, just as the kidneys, whose function it is to
attract the urine, do this badly when they are out or order, so
also the spleen, which has in itself a native power of attracting
an atrabiliary quality,if it ever happens to be weak, must
necessarily exercise this attraction badly, with the result that
the blood becomes thicker and darker.
Now all these points, affording as they do the greatest help in
the diagnosis and in the cure of disease were entirely passed over
by Erasistratus, and he pretended to despise these great men- he
who does not despise ordinary people, but always jealously attacks
the most absurd doctrines. Hence, it was clearly because he had
nothing to say against the statements made by the Ancients
regarding the function and utility of the spleen, and also because
he could discover nothing new himself, that he ended by saying
nothing at all. I, however, for my part, have demonstrated,
firstly from the causes by which everything throughout nature is
governed (by the causes I mean the Warm, Cold, Dry and Moist) and
secondly, from obvious bodily phenomena, that there must needs be
a cold and dry humour. And having in the next place drawn
attention to the fact that this humour is black bile [atrabiliary]
and that the viscus which clears it away is the spleen- having
pointed this out by help of as few as possible of the proofs given
by ancient writers, I shall now proceed to what remains of the
subject in hand.
What else, then, remains but to explain clearly what it is that
happens in the generation of the humours, according to the belief
and demonstration of the Ancients? This will be more clearly
understood from a comparison. Imagine, then, some new wine which
has been not long ago pressed from the grape, and which is
fermenting and undergoing alteration through the agency of its
contained heat. Imagine next two residual substances produced
during this process of alteration, the one tending to be light and
air-like and the other to be heavy and more of the nature of
earth; of these the one, as I understand, they call the flower and
the other the lees. Now you may correctly compare yellow bile to
the first of these, and black bile to the latter, although these
humours have not the same appearance when the animal is in normal
health as that which they often show when it is not so; for then
the yellow bile becomes vitelline, being so termed because it
becomes like the yolk of an egg, both in colour and density; and
again, even the black bile itself becomes much more malignant than
when in its normal condition, but no particular name has been
given to [such a condition of] the humour, except that some people
have called it corrosive or acetose, because it also becomes sharp
like vinegar and corrodes the animal's body- as also the earth, if
it be poured out upon it- and it produces a kind of fermentation
and seething, accompanied by bubbles- an abnormal putrefaction
having become added to the natural condition of the black humour.
It seems to me also that most of the ancient physicians give the
name black humour and not black bile to the normal portion of this
humour, which is discharged from the bowel and which also
frequently rises to the top [of the stomach-contents]; and they
call black bile that part which, through a kind of combustion and
putrefaction, has had its quality changed to acid. There is no
need, however, to dispute about names, but we must realise the
facts, which are as follow:-
In the genesis of blood, everything in the nutriment which belongs
naturally to the thick and earth-like part of the food, and which
does not take on well the alteration produced by the innate heat-
all this the spleen draws into itself. On the other hand, that
part of the nutriment which is roasted, so to speak, or burnt
(this will be the warmest and sweetest part of it, like honey and
fat), becomes yellow bile, and is cleared away through the
so-called biliary vessels; now, this is thin, moist, and fluid,
not like what it is when, having been roasted to an excessive
degree, it becomes yellow, fiery, and thick, like the yolk of
eggs; for this latter is already abnormal, while the previously
mentioned state is natural. Similarly with the black humour: that
which does not yet produce, as I say, this seething and
fermentation on the ground, is natural, while that which has taken
over this character and faculty is unnatural; it has assumed an
acridity owing to the combustion caused by abnormal heat, and has
practically become transformed into ashes. In somewhat the same
way burned lees differ from unburned. The former is a warm
substance, able to burn, dissolve, and destroy the flesh. The
other kind, which has not yet undergone combustion, one may find
the physicians employing for the same purposes that one uses the
so-called potter's earth and other substances which have naturally
a combined drying and chilling action.
Now the vitelline bile also may take on the appearance of this
combusted black bile, if ever it chance to be roasted, so to say,
by fiery heat. And all the other forms of bile are produced, some
the from blending of those mentioned, others being, as it were,
transition-stages in the genesis of these or in their conversion
into one another. And they differ in that those first mentioned
are unmixed and unique, while the latter forms are diluted with
various kinds of serum. And all the serums in the humours are
waste substances, and the animal body needs to be purified from
them. There is, however, a natural use for the humours first
mentioned, both thick and thin; the blood is purified both by the
spleen and by the bladder beside the liver, and a part of each of
the two humours is put away, of such quantity and quality that, if
it were carried all over the body, it would do a certain amount of
harm. For that which is decidedly thick and earthy in nature, and
has entirely escaped alteration in the liver, is drawn by the
spleen into itself; the other part which is only moderately thick,
after being elaborated [in the liver], is carried all over the
body. For the blood in many parts of the body has need of a
certain amount of thickening, as also, I take it, of the fibres
which it contains. And the use of these has been discussed by
Plato, and it will also be discussed by me in such of my treatises
as may deal with the use of parts. And the blood also needs, not
least, the yellow humour, which has as yet not reached the extreme
stage of combustion; in the treatises mentioned it will be pointed
out what purpose is subserved by this.
Now Nature has made no organ for clearing away phlegm, this being
cold and moist, and, as it were, half-digested nutriment; such a
substance, therefore, does not need to be evacuated, but remains
in the body and undergoes alteration there. And perhaps one cannot
properly give the name of phlegm to the surplus-substance which
runs down from the brain, but one should call it mucus [blenna] or
coryza- as, in fact, it is actually termed; in any case it will be
pointed out, in the treatise "On the Use of Parts," how Nature has
provided for the evacuation of this substance. Further, the device
provided by Nature which ensures that the phlegm which forms in
the stomach and intestines may be evacuated in the most rapid and
effective way possible- this also will be described in that
commentary. As to that portion of the phlegm which is carried in
the veins, seeing that this is of service to the animal, it
requires no evacuation. Here too, then, we must pay attention and
recognise that, just as in the case of each of the two kinds of
bile, there is one part which is useful to the animal and in
accordance with its nature, while the other part is useless and
contrary to nature, so also is it with the phlegm; such of it as
is sweet is useful to the animal and according to nature, while,
as to such of it as has become bitter or salt, that part which is
bitter is completely undigested, while that part which is salt has
undergone putrefaction. And the term "complete indigestion" refers
of course to the second digestion- that which takes place in the
veins; it is not a failure of the first digestion- that in the
alimentary canal- for it would not have become a humour at the
outset if it had escaped this digestion also.
It seems to me that I have made enough reference to what has been
said regarding the genesis and destruction of humours by
Hippocrates, Plato, Aristotle, Praxagoras, and Diocles, and many
others among the Ancients; I did not deem it right to transport
the whole of their final pronouncements into this treatise. I have
said only so much regarding each of the humours as will stir up
the reader, unless he be absolutely inept, to make himself
familiar with the writings of the Ancients, and will help him to
gain more easy access to them. In another treatise I have written
on the humours according to Praxagoras, to Praxagoras, son of
authority Nicarchus; although this authority makes as many as ten
humours, not including the blood (the blood itself being an
eleventh), this is not a departure from the teaching of
Hippocrates; for Praxagoras divides into species and varieties the
humours which Hippocrates first mentioned, with the demonstration
proper to each.
Those, then, are to be praised who explain the points which have
been duly mentioned, as also those who add what has been left out;
for it is not possible for the same man to make both a beginning
and an end. Those, on the other hand, deserve censure who are so
impatient that they will not wait to learn any of the things which
have been duly mentioned, as do also those who are so ambitious
that, in their lust after novel doctrines, they are always
attempting some fraudulent sophistry, either purposely neglecting
certain subjects, as Erasistratus does in the case of the humours,
or unscrupulously attacking other people, as does this same
writer, as well as many of the more recent authorities.
But let this discussion come to an end here, and I shall add in
the third book all that remains.
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